President Trump and the GOP love to position themselves as champions of the common man. They frequently appeal to rural Americans, framing this demographic as a critical part of the Republican base.

It’s true that many rural Americans harken to conservative philosophies, but with campaign season over, much of what they were promised hasn’t arrived. Case-in-point: health care.

There are few demographics with so much to gain from a single-payer system than those living in the countryside, but party-line politics are keeping them from subscribing.

To Live and Die in the Country

Few sovereign nations on the planet can even offer the vast areas Americans have access to as habitable. Part of the reason for this is that small communities make it simpler to service residents and develop infrastructure.

Rural Americans exhibit characteristics different from their suburbanite cousins. People are older on average and must travel farther to receive health care. Many are poor and lack a reliable means of transportation to visit their doctor. Beyond that hurdle, they still face the challenge of paying for care.

With smaller communities, there is less work and less incentive for medical facilities to be built. As the market shifts ever more in the direction of expensive care, more hospitals are closing in poor communities and reopening in affluent, urban ones. Key indicators like infant mortality rate and average age of death show that living in a rural or poor area can have serious effects on your health in the United States.

Why Single-Payer Could Help

Those who are suffering this unfair treatment would benefit from a single-payer system because it provides a uniform standard of care for all. Rather than money going to fancy uptown hospitals, rural facilities could receive the autonomy needed to provide for their unique community.

For example, the private system we have now encourages large companies that own multiple hospitals to shut down rural operations because of their lower profitability. However, that decision comes with consequences for the people who live in rural areas. Since health care isn’t a right in the United States, the market is deciding for them that they shouldn’t have it.

In a single-payer system, capital investment from the government would be distributed even to those hospitals that can’t be as profitable because of their location. This would allow things like new diagnostic equipment for remote hospitals, which could lead to longer lives and lower infant mortality.

The Stigma of Single-Payer

Unfortunately, conservative thought-leaders have essentially poisoned the well for those who desperately need health care reform by painting single-payer as socialized medicine. If you look at the arguments against socialized health care — which can and does work when well-implemented — they are the same as those against our current system.

Not only are rural Americans already burdened with long waits for care because of the understaffed facilities they are driven to, but they are also paying through the nose for it. About 100 million Americans go without professionally recommended medical care each year due to cost. A single-payer system would significantly reduce overall costs, thereby making procedures much more affordable even for rural inhabitants who make a humble salary.

Close, but No Cigar

We have seen attempts in the past to establish a system like this. Most recently, US Sen. Bernie Sanders championed the idea of Medicare for all during his 2016 presidential run. America is still the only developed country on the planet with for-profit insurance companies. Why is that?

It’s remarkable that we have convinced ourselves that 45,000 deaths per year attributed to lack of health insurance is somehow acceptable when no other developed nation lives that way. People living in rural areas should be the most prominent proponents of this thinking.

Broken Communication

Unfortunately, Democrats who’ve promoted this system in the past have committed real mistakes in the way they’ve approached rural communities. Donald Trump’s campaign famously seized on Hillary Clinton’s use of the word “deplorables” as the adjective-of-choice for poor, rural whites. How are rural Americans supposed to trust someone they think resents them?

Better education needs to make its way into these communities. Without access to both sides of the picture, conservative influencers are capitalizing on the few community leaders that spread the news through church communities and other small organizations. Liberals need to rethink their approach.

Health care reform is something we need badly in this country. The key is helping the various demographics of people to understand why they need it, and how they can be the instruments of their own salvation.

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